Healthcare Provider Details

I. General information

NPI: 1043468317
Provider Name (Legal Business Name): HUFFMAN FAMILY CHIROPRACTIC, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2008
Last Update Date: 08/28/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2030 E 38TH ST
ERIE PA
16510-3607
US

IV. Provider business mailing address

2030 E 38TH ST
ERIE PA
16510-3607
US

V. Phone/Fax

Practice location:
  • Phone: 814-825-2129
  • Fax:
Mailing address:
  • Phone: 814-825-2129
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC009968
License Number StatePA

VIII. Authorized Official

Name: DR. JOHN DANIEL HUFFMAN
Title or Position: OWNER
Credential: D.C.
Phone: 814-825-2129